Academic journal article European Journal of Psychotraumatology

Trauma-Related Altered States of Consciousness in Women with BPD with or without Co-Occurring PTSD

Academic journal article European Journal of Psychotraumatology

Trauma-Related Altered States of Consciousness in Women with BPD with or without Co-Occurring PTSD

Article excerpt

CLINICAL RESEARCH ARTICLE

Trauma-related altered states of consciousness in women with BPD with or without co-occurring PTSD

Paul Frewen1,2,3, Nikolaus Kleindienst4, Ruth Lanius1,3 and Christian Schmahl4*

1Department of Psychiatry, Western University, London, ON, Canada; 2Department of Psychology, Western University, London, ON, Canada; 3Graduate Program in Neuroscience, Western University, London, ON, Canada; 4Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Mannheim, Germany

Abstract

Background : A "4-D model" was recently described as a theoretical framework for categorizing trauma-related symptoms into four phenomenological dimensions (the experience of time, thought, body, and emotion) that can present either in the form of normal waking consciousness (NWC) or as dissociative experiences, that is, trauma-related altered states of consciousness (TRASC).

Methods : The present study examined the predictions of the 4-D model in 258 persons with borderline personality disorder (BPD) with (n =126) versus without (n =132) posttraumatic stress disorder (PTSD).

Results : As measured by the Borderline Symptom List , consistent with the predictions of the 4-D model, in comparison with symptom endorsements theorized to be associated with NWC, measures of TRASC were less frequent, and more strongly correlated with both Dissociative Experience Scale scores and severity of childhood emotional neglect, particularly in persons with both BPD and PTSD. Our prediction that symptoms of TRASC would be less intercorrelated in comparison with distress associated with NWC symptoms, however, was not supported.

Conclusions : Findings are discussed as they pertain to the symptomatology of BPD, PTSD, and dissociation.

Keywords: Dissociation; borderline personality disorder; posttraumatic stress disorder; trauma-related altered states of consciousness; childhood abuse and neglect; 4-D model

Responsible Editor: Julian D. Ford, University of Connecticut Health Center, United States.

*Correspondence to: Christian Schmahl, Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Mannheim, Germany, Email: christian.schmahl@zi-mannheim.de

For the abstract or full text in other languages, please see Supplementary files under Article Tools online

Received: 6 May 2014; Revised: 1 July 2014; Accepted: 3 July 2014; Published: 18 August 2014

European Journal of Psychotraumatology 2014. © 2014 Paul Frewen et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported (CC BY 4.0) License (http://creativecommons.org/licenses/by/4.0/), allowing third parties to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material, for any purpose, even commercially, under the condition that appropriate credit is given, that a link to the license is provided, and that you indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

Citation: European Journal of Psychotraumatology 2014, 5 : 24863 - http://dx.doi.org/10.3402/ejpt.v5.24863

Borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) as defined by the fourth edition of the Diagnostic and Statistical Manual (DSM) are frequently comorbid psychiatric conditions. Studies show that between 35 and 55% of BPD patients suffer from comorbid PTSD (Zanarini et al., 1998; Zimmermann, 1999) and, compared with patients with other personality disorders, BPD patients are approximately twice as likely to have a co-occurring diagnosis of PTSD (Golier et al., 2003). Moreover, attending to the presence of PTSD comorbidity within BPD samples is clinically significant given that tendencies toward self-harm and suicidality may be increased in individuals with comorbid PTSD relative to BPD alone (Cougle, Keough, Riccardi, & Sachs-Ericsson, 2009; Harned, Rizvi, & Linehan, 2010; Nepon, Belik, Bolton, & Sareen, 2010; Pagura et al. …

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